Objective: To evaluate the experience of surgical treatment of anastomotic recurrence following resection of esophageal carcinoma. Methods: Reoperation was performed in 11 patients with anastomotic recurrence. The surgical procedure performed included cervical esophagocolostomy in 5, cervical esophagogastrostomy in 3, esophagocolostomy and esophagogastrostomy at the top of chest in 2, respectively, and thoracotomy in 1. Results: There was one operative death with mortality rate of 9.1%. The cause of death was respiratory failure. 1-, 3-and 5-year survival rates were 77.8% (7/9), 44.4% (4/9) and 22.2% (2/9), respectively. Conclusion: Reoperation is still effective for some patients with anastomotic recurrence. Early diagnosis and prompt surgical treatment can improve the outcome.

Objective To evaluate the efficacy and feasibility of percutaneous microwave coagulation therapy(PMCT) combined with 125I seeds implantation for the treatment of advanced lung cancer.Methods CT-guided PMCT and implantation of 125I seeds were applied to 22 cases of NSCLC,including 15 cases of squamous carcinoma and 7 cases of adenocarcinoma.The maximum diameter of the lesions ranged from 5-12 cm.The part of focuses situated at thoracic wall or surrounding the large vessels and airways was treated with 125I seed implantation,and the other parts were treated with PMCT. Results In all the patients,PMCT was done in one session with multipoint ablation,and an average of 32.4 particles of 125I seeds were implanted for each of the focuses(712 particles in total).The main postoperative complications included slight hemoptysis(7 cases),pneumothorax(4 cases),fever(17) and lung inflammation(11) after PMCT,chest fluid(6),and dislocation of the particles(2).15 cases achieved PR,5 cases were SD,and 2 cases were PD in 2 months after the operation shown by CT.The effective rate(CR + PR) was 68.2%(15/22).The chest pain was relieved in 15 patients,and improved in 4.22 of the cases were followed up for 4 to 18 months(mean 7 months).No enlargement of the chest lesion was detected during the period. Conclusions For the advanced NSCLC sized ≥ 5 cm in diameter,PMCT combined with 125I seeds implantation is safe,minimally invasive,and effective.

Objective To evaluate the function of residual esophagus and stomach after subtotal esophagectomy and cervical gastroesophagostomy for esophageal carcinoma. Methods Manometry was performed in 21 patients who underwent cervical anastomosis after subtotal esophageal resection. The data was compared with normal subjects. Results The mean value of pharyngeal resting pressure was (1.20?2.03) mmHg(1mmHg=0.133kPa), and that of contraction pressure was (72.37?16.95) mmHg. The resting pressure of upper esophageal sphincter (UES) was (28.20?15.60) mmHg, and closing pressure was (107.10?28.43) mmHg. The resting pressure of residual esophagus was (15.98?11.10) mmHg, and contraction pressure was (48.45?18.37) mmHg. The resting pressure of stomach was (3.53?3.30) mmHg. Incidence of primary wave of esophagus was (57.14?34.50)%. The resting pressure of residual esophagus was much higher than that of normal group (P

Objective: To investigate the relationship of nm23 and VEGF expression with hilar lymph node micrometastasis and the prognosis of stage Ⅰ non-small cell lung cancer (NSCLC). Methods: Immunohisto-chemistry was used to detect nm23 and VEGF protein expression in primary cancer tissue and cytokeratins in 86 hilar lymph nodes from 40 patients with stage Ⅰ NSCLC. Kaplan-meier method and Log rank test were used to analyze the 5-year survival. Results: The rate of positive hilar lymph node micrometastasis was 12.5% for stage Ⅰ NSCLC. Lymph node micrometastasis was not statistically correlated with gender, age, histologic type, differentiation, primary tumor size or VEGF protein expression (P>0.05). But it was reversely associated with nm23 protein expression in primary cancer tissue of NSCLC (P<0.05). The 5-year overall survival of pa-tients with well-differentiated NSCLC, positive nm23 expression and negative lymph node micrometastasis was better than those with moderately and poorly differentiated NSCLC, negative nm23 expression and posi-tive lymph node micrometastasis (P<0.05). Lymph node micrometastasis and nm23 protein expression were identified as two independent prognostic factors for stage Ⅰ NSCLC by univariate Cox regression analysis.Conclusion: nm23 protein expression in pdmary cancer tissue of stage Ⅰ NSCLC is closely associated with hi-lar lymph node micrometastasis, nm23 protein and hilar lymph node micrometastasis are two independent prognostic factors for stage Ⅰ NSCLC. Patients with nm23 protein deletion and positive lymph node microme-tastasis have a poor prognosis.

Objective To investigate the influence of injection color regents concentration on completed resection rate, operation time and injection volume of patients with intestinal tumor by ESD.Methods 90 elderly patients with intestinal tumor by ESD were chosen from June 2013 to June 2016. They were randomly divided into 3 groups including A group (30 patients) with glycerin fructose used alone, B group (30 patients) with glycerin fructose combined with 2% mythylene blue on the basis of glycerin fructose and C group (30 patients) with glycerin fructose combined with 4% mythylene blue on the basis of glycerin fructose; and the completed resection rate of tumor, operation time, injection volume and complication incidence in the peri-operative period of 3 groups were compared.Results There was no signiifcant difference in the completed resection rate of tumor among the 3 groups (P < 0.05). The operation time and injection volume of C group were signiifcant better than A group and B group (P< 0.05). There was no signiifcant difference in operation time and injection volume between A group and B group (P < 0.05). There was no signiifcant difference in the complication incidence in the peri-operative period among the 3 groups (P < 0.05).Conclusion Compared with glycerin fructose used alone and glycerin fructose combined with 1% mythylene blue for 2 mg, glycerin fructose combined with 1% mythylene blue for 4 mg by intestinal submucosal injection on patients with intestinal tumor by ESD can efifciently shorten the operation time and reduce the injection volume.

A patient suffering Madelung's disease was treated and the literatures were reviewed in this article. The cause, the clinical features and treatment were discussed. The cause of this disease is unknown, and it is characterized by symmetrical accumulation of fat around the neck,nape and armpit having a appearance of "horse collar"or "hump back". Histological analysis revealed typical fat tissue depositing around the structures. Surgery is the main means of treatment, and prognosis is good.

ObjectiveTo evaluate the efficacy, feasibility and safety of CT guided percutaneous 125Ⅰ seeds implantation in elderly patients of stage Ⅰperipheral non-small cell lung cancer ( NSCLC ).MethodsClinical data of 16 elderly peripheral stage Ⅰ NSCLC patients ( 10 squamous carcinoma and 6adenocarcinoma;13 stage ⅠA and 3 stage ⅠB ) who received radioactive 125Ⅰ seeds implantation because of refusal or being unsuited to operation or external radiotherapy were retrospectively analyzed. Prescribed dose was 140 - 160 Gy. Under CT guidance, 125Ⅰ seeds were implanted percutaneously into tumors for interstitial radiotherapy according to treatment plan system. ResultsMean number of 125Ⅰ seeds each patient received was21.1. 12 complete response (CR) and 4 partial response (PR) were achieved. Total response rate ( CR + PR) was 100％. 100％ patients completed 10 to 56 months of follow-up, 15, 13, 8 and 6 patients completed 1-, 2-, 3-and 4-years'follow-up, respectively. The median local progression free time was 14months. The 1-,2-,3-and 4-year overall survival rate were 60％, 54％, 50％ and 33％, respectively (median:14 months). 7 cases died of non-tumor disease and 5 died of metastasis. No severe complications were observed. ConclusionsCT guided 125Ⅰ seeds implantation is a safe, reliable and effective radical treatment method for elderly stage Ⅰ peripheral NSCLC patients, who refuse to or are unsuitable to operation or external radiotherapy.

ObjectiveTo examine the expressions of amplified in breast cancer 1(AIB1) and epithelial cadherin (E-cadherin) in ovarian carcinoma (OC) tissues,and determine the correlation between the expression and clinical pathological features.MethodsThe expression of AIB 1,E-cadherin,estrogen receptor (ER),progesterone receptor (PR) and Ki-67 in tissues of 50OCs and 13 normal ovarians tissues were detected by immunohistochemistry(IHC) EnVision two step process analysis.ResultsPositive expression of AIB1 in OC tissues[68％(34/50) ] was obviously higher than that in normal ovarian tissues [8％ (1/13)] (P ＜0.01).Down-regulation of E-cadherin expression was 60％ (30/50).The positive expression of AIB1 was significantly higher in stage Ⅲ and Ⅳ than in stage Ⅰand Ⅱ according to International Federation of Gynecology and Obstetrics (FIGO) stage (P =0.036),in lymph node metastasis group than in none lymph node metastasis group ( P =0.027 ),in stage G3 than in stage G1 and G2 according to Silverberg stage (P =0.003),and in serous adenocarcinoma group than in non-serous adenocarcinoma group (P=0.049);positive rates of ER and Ki-67 were higher than negative rates of ER(P=0.000) and Ki-67 (P =0.009) respectively.Down-regulation of E-cadherin expression was higher in FIGO stage Ⅲ and Ⅳ than in stage Ⅰ and Ⅱ (P =0.044),in serous adenocarcinoma group than in non- serous adenocarcinoma group ( P =0.022) ; positive rates of ER and Ki-67 were higher than negative rates of ER ( P =0.02 1 ) and Ki-67 (P=0.035) respectively.The expression of AIB1 was negatively correlated with E-cadherin expressioh (P =0.026).ConclusionsThe expressions of AIB1 and E-cadherin in OC tissues is closely related to clinical stage.Therefore,AIB1 and E-cadherin may be important moleculars involved in the progression of OC.

Objective To study the expression characteristics of Let-7 genes in breast cancer.Methods Twenty-eight patients with breast cancer were randomly selected,and their cancer tissue and adjacent normal tissue were collected.TRIzol was used to extract the total RNA and real-time quantitative PCR was used to detect the relative gene expression levels.Results The expression of precursor Let-7 in cancer tissue was (9.65 ± 2.31),which was lower than that in normal tissue (10.05 ± 2.81),P =0.048.Precursor Let-7 had dependence relationship with the long menstruation (b =0.816,P =0.029).The menarche age showed a positive correlation with precursor Let-7 in normal tissue (r =0.502,P =0.048) and a negative correlation in cancer tissue (r =-0.484,P =0.049) Conclusions The expression of precursor Let-7 in cancer tissue is lower than that in normal tissue.The period of menstruation is a protective factor to breast cancer.

Objective To study the role of vagusism on diethytlnitrosamine (DEN)-induced hepatocellular carcinoma in rats and to explore its mechanism.Methods The rat vagus nerve was labeled with 1,1'-dioctadecyl-3,3,33 -tetramethylindocarbocyanine perchlorate (DiI) tracer.The rats were divided into three groups:cancer induced rat models (cancer-induced group,n =20),cancer-induced and vagal detachment models (combined group,n =20) and normal rats (negative group,n =20),HE staining was performed on the liver tissue biopsied from the three groups of rats.The pathological grading score was evaluated and statistically analyzed.Immunohistochemistry (IHC) staing was used to determine the expression of vagal neurotransmitters and related receptors in liver tissue.Results The optimal concentration (1 mg/ml) and fixation duration with formalin (4 days) of DiI tracer marker vagal nerve demonstrated superior distribution and density of vagus nerve in the liver tissue.The incidence of hepatocellular carcinoma was significantly higher in the cancer-induced group (75％) than combined group (15％),the difference was statistically significant (P ＜ 0.05).IHC staining results of acetllcholine showed a significant difference between cancerinduced group (9.10) and combined group (2.30) or negative group (2.95),the difference was statistically significant (P ＜ 0.05).The M1 receptor expression was significantly higher in cancer-induced group (6.00) than combined group (2.30) and negative group (2.55),the differences were statistically significant (P ＜ 0.05).There was no significant difference of M2 receptor expression among the cancer-induced group (1.30),combined group (1.25) and negative group (1.35) (P ＞ 0.05).The M3 receptor expression detected with IHC staining shown there were statistical differences among cancer-induced group (8.95),combined group (6.30) and negative group (3.60) (all P ＜ 0.05).Conclusion The vagus nerve may play an important role in the development of DEN-induced hepatocellular carcinoma in rats.